Laparoscopic vs. open total abdominal colectomy for severe colitis: impact on recovery and subsequent completion restorative proctectomy

T Philip Chung, James W Fleshman, Elisa H Birnbaum, Steven R Hunt, David W Dietz, Thomas E Read, Matthew G Mutch
Diseases of the Colon and Rectum 2009, 52 (1): 4-10

PURPOSE: This study was designed to compare short-term outcomes of laparoscopic vs. open total abdominal colectomy and end ileostomy for severe ulcerative colitis and to evaluate the impact of the initial surgical approach on subsequent operations for three-stage restorative proctocolectomy.

METHODS: Perioperative demographic and outcome data for patients with severe ulcerative colitis who underwent laparoscopic (n = 37) or open (n = 41) total abdominal colectomy at the initial stage of a three-stage restorative proctocolectomy were compared. Each stage was analyzed independently by using two-tailed t-tests and analysis of covariance.

RESULTS: Patients who underwent laparoscopic total abdominal colectomy had higher serum albumin (P = 0.0003), less inpatient narcotic usage (P = 0.0143), faster return of bowel function (P = 0.0001), and shorter length of stay (P = 0.039). There were no differences in perioperative parameters for the restorative proctectomy and ileostomy closure. The laparoscopic total abdominal colectomy patients underwent subsequent restorative proctectomy 49 days sooner (P = 0.0044) and ileostomy closure 17 days sooner (P = 0.00003) than the open total abdominal colectomy patients.

CONCLUSIONS: Laparoscopic abdominal colectomy for severe ulcerative colitis in selected patients is safe and is associated with short-term benefits that may lead to faster recovery and progression to completion of restorative proctocolectomy.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"